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Post-term Pregnancy

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Post-term Pregnancy

(Postdate Pregnancy; Postdates; and Prolonged Pregnancy)

Definition

A typical pregnancy lasts 38-42 weeks. A post-term pregnancy lasts beyond 42 weeks. The risk for certain health problems is higher in post-term pregnancies than in full-term pregnancies. This condition requires additional care and monitoring from your doctor.

Causes

The exact cause of a prolonged pregnancy is unknown. About 5%-10% of pregnancies become post-term.

Risk Factors

Previous post-term pregnancy is the most common risk factor.

Symptoms

If you are still pregnant after your due date, see your doctor.

Diagnosis

Your doctor will review your history to make sure that your due date is correct. Your doctor may recommend:
  • Ultrasound—To measure amniotic fluid and see how much your baby is moving
  • Fetal monitoring—To check the baby's heartbeat
To see if your body is preparing for labor, your doctor may also check your cervix to see if it is opening and thinning.

Treatment

Talk with your doctor about the best treatment plan for you. Treatment options include the following:

Expectant Management

Some women and their doctors choose to wait for labor to begin on its own. During this wait and see period, the doctor will closely monitor the baby’s heart rate, amniotic fluid levels, breathing, and movement. If there are any signs of problems or your pregnancy continues beyond 42 weeks, your doctor may recommend labor induction.

Labor Induction

If labor has not started naturally, there are a number of ways your doctor can try to induce labor.
  • Medications can help the soften and open the cervix.
  • A small tear is made in your amniotic sac to break your water. This is painless and can triggers contractions.
  • Your doctor may do a membrane sweep. Your doctor uses a finger to sweep around the neck of your cervix to separate it from the membranes around your baby. This action releases hormones called prostaglandins, which may induce labor.
  • Your doctor may give you a medication called oxytocin. Oxytocin starts contractions and helps them to remain strong and regular.
In general, women with a post-term pregnancy who have an induced labor are less likely to need a Cesarean delivery than women who wait for labor to begin naturally.
Full Term Fetus with Intact Membranes
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Copyright © Nucleus Medical Media, Inc.

Prevention

There is little that can be done in advance to reduce your chances of having a post-term pregnancy. If your pregnancy lasts beyond 42 weeks, talk to your doctor before trying any home remedies for starting labor. Most home remedies are unproven and some may be harmful to you or your baby.

RESOURCES

American Academy of Family Physicians Family Doctor http://familydoctor.org

The American Congress of Obstetricians and Gynecologists http://www.acog.org

CANADIAN RESOURCES

The Canadian Women's Health Network http://www.cwhn.ca

The Society of Obstetricians and Gynaecologists of Canada http://www.sogc.org

References

Briscoe D, Nguyen H, Mencer M, et al. Management of pregnancy beyond 40 weeks’ gestation. Am Fam Physician. 2005;71:1935-1941.

Labor induction. American Academy of Family Physicians Family Doctor website. Available at: http://familydoctor.org/familydoctor/en/pregnancy-newborns/labor-childbirth/labor-induction.html . Updated August 2010. Accessed April 23, 2013.

Labor induction and cervical ripening. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php. Updated April 1, 2013. Accessed April 23, 2013.

Management of post-term pregnancy. The American Congress of Obstetricians and Gynecologists. Practice Bulletin No. 55, September 2004. (Reaffirmed 2011.)

Postdates pregnancy. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php. Updated August 21, 2012. Accessed April 23, 2013.

Pregnancy: what to expect when your due date has passed. American Academy of Family Physicians Family Doctor website. Available at: http://familydoctor.org/familydoctor/en/pregnancy-newborns/labor-childbirth/pregnancy-what-to-expect-when-youre-past-your-due-date.html. Updated August 2010. Accessed April 23, 2013.

Sanchez-Ramos L, Olivier F, Delke I, et al. Labor induction versus expectant management for post-term pregnancies: a systematic review with meta-analysis. Obstet Gynecol. 2003;101(6):1312-1318.

Revision Information

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.

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